{"title":"Radial and focused shock waves in Bascharage","seoTitle":"Radial and focused shock waves in Bascharage | Physiotherapy PES Luxembourg","metaDescription":"How radial and focused extracorporeal shock waves are used as an adjunct in physiotherapy at Pôle Équilibre & Santé in Bascharage.","content":"**Extracorporeal shock waves (ESWT) are high-energy acoustic pulses, applied to a tendon, a fascia or a calcification. At Pôle Equilibre & Santé, in Bascharage, the practice has a radial Swiss DolorClast (ballistic, more superficial) and a DolorClast Focused / PiezoClast (piezoelectric, deeper). They remain an adjunct to a tendon-loading programme, never a stand-alone treatment.**\n\n## A pressure wave, not an electric current\n\nESWT is not electricity. A coupling gel transmits a mechanical pulse through the skin. The stimulus can modulate pain and influence the local metabolism of a chronic tissue; it does not fracture the tendon and does not replace loading work, which remains first-line treatment for tendinopathies.\n\nTwo generators, two depths:\n\n- **radial** ([EMS Swiss DolorClast](https://www.ems-dolorclast.com/dolorclastr-radial-shock-waves-0)): a ballistic projectile strikes an applicator; energy spreads over a wider area, to about **0–4/5 cm**, useful for superficial tendons, the plantar fascia and certain myofascial points;\n- **focused** ([DolorClast Focused / PiezoClast](https://www.ems-dolorclast.com/products/dolorclastr-focused-shock-waves)): piezoelectric crystals concentrate energy in depth on a narrow target, notably a shoulder calcification or a deep insertion.\n\nThe choice depends on tissue depth, imaging when it is relevant, your tolerance and the clinical goal — not on maximal intensity.\n\n## Indications: what we retain, and what we do not promise\n\nThe traditionally best-supported indications are:\n\n- **plantar fasciitis** (first-step pain, sometimes associated with a calcaneal spur);\n- certain **shoulder calcifications**, when the clinical picture and imaging agree.\n\nOther tendons (patellar, epicondylalgia, rotator cuff) can be discussed case by case, always as an **adjunct** to a loading programme. A recent tendinopathy that is still very inflammatory is generally not the right moment.\n\nAchilles tendinopathy is **not** presented here as a routine indication. See below.\n\n## What the recent literature says\n\nProgressive tendon loading remains the foundation of rehabilitation. Shock waves usefully add to it for certain carefully selected indications — plantar fasciitis, shoulder calcifications, chronic tendinopathies — to help ease pain and restart active work.\n\nFor the Achilles tendon, the loading programme remains the **priority**. Shock waves can be discussed case by case according to the assessment, always integrated into a [sports physiotherapy](/bascharage/competence/kinesitherapie-du-sport) plan, possibly crossed with a strength assessment on [isokinetic testing](/bascharage/equipement/isocinetisme) or eccentric work on a [flywheel](/bascharage/equipement/iso-inertiel).\n\nAn international Delphi consensus (Rhim et al., *BJSM*, 2025) proposes recommendations for use in sports medicine (terminology, precautions, procedural aspects): a useful framework to standardise practice in the clinic.\n\n## How a session goes\n\nAfter the assessment and locating the area, gel is applied. The applicator delivers pulses for about **eight to twelve minutes**. Intensity is adapted to your tolerance: frank discomfort is common; intolerable pain is not the goal. Prior cooling, via [compressive cryotherapy](/bascharage/equipement/cryotherapie), can improve comfort on a very sensitive area.\n\nA protocol is **not universal**. Often **five to eight sessions**, **five to seven days** apart, according to the indication, the device and tolerance. The exact number depends on the tissue, how long symptoms have lasted and the response. With fewer than three applications, follow-up is often insufficient; beyond that, we reassess rather than continue out of habit.\n\n## Preparation\n\nAccessible area (shorts for an Achilles tendon or a sole, a vest for a shoulder). Clean skin, without cream, oil, a patch or thick make-up. Remove watches and jewellery nearby. You do not need to be fasting. Mention an anticoagulant, pregnancy, a skin infection or a known tumour in the region. Avoid a strong painkiller just before: sensation guides the setting. Usual paracetamol is generally not an obstacle.\n\n## After the session\n\nLocal redness or tenderness to touch are possible the same evening. Intense loading of the treated tendon is then avoided for **one to two days**. Walking, desk work and driving generally remain possible. In case of sudden pain, a large haematoma or fever, contact the practice.\n\n## Contraindications\n\nInfection, an open wound, a tumour in the area, the abdomen of a pregnant woman. A coagulation disorder, an anticoagulant or a growth plate in a child lead us to reconsider the indication. A very recent tendinopathy is generally not the moment to apply.\n\n## Frequently asked questions\n\n\nIs it painful during the application?
\n\nDiscomfort is common and varies with the area (the sole and the Achilles insertion are often more sensitive). Intensity is set with you.\n\n \n\n\nHow many sessions, and at what rhythm?
\n\nMost often five to eight applications, five to seven days apart. The rhythm is decided after the assessment, not on a package deal.\n\n \n\n\nDo shock waves heal an Achilles tendon?
\n\nThey can form part of the plan when the assessment justifies it, always **combined** with the loading programme, which remains the foundation. The physiotherapist chooses the indication case by case.\n\n \n\n\nCan I work and drive afterwards?
\n\nYes in the great majority of cases. Expect a sensitive area when putting on shoes. Avoid intense sport on the treated tendon for 24 to 48 hours.\n\n \n\n\nDo shock waves replace the exercises?
\n\nNo. Without a loading programme, there is no tendinopathy treatment. The exercises — sometimes on a [flywheel](/bascharage/equipement/iso-inertiel) — remain the foundation.\n\n \n\n\nIs a prescription required?
\n\nPhysiotherapy is provided on medical prescription so that it can be reimbursed by the [CNS](https://cns.public.lu/fr/assure/remboursements/prestations-remboursees/prestations-paramedicales/kinesitherapeutes.html). The practice handles the paperwork. Details: [The Consultation](/bascharage/kinesitherapie/consultation-kine).\n\n \n\n\nHow can I book an appointment?
\n\nVia [Doctena](https://fr.doctena.lu/cabinet/Pole_Equilibre_Sante-281318) or on +352 26 65 28 42. Practice at 20B Rue du Bois, 4912 Bascharage — see [Contact & access](/contact).\n\n \n\n## Find out more\n\n- [Sports physiotherapy](/bascharage/competence/kinesitherapie-du-sport) — reloading the tendon\n- [Iso-inertial training](/bascharage/equipement/iso-inertiel) — controlled eccentric work\n- [Our technical platform](/bascharage/equipement)\n\n","image":"https://pes-luxembourg.lu/bascharage/wp-content/uploads/sites/2/2019/09/Ondes-de-choc.png"}